Wednesday, February 28, 2024


Written & produced by: Dr. Robert Bard

I'm a radiologist subspecializing in ultrasound imaging, and I've been doing breast scanning for over 35 years. We have advanced radiology from x-rays to ultrasound to MRI and beyond. Reports are now promoting certain cancers should be considered as chronic diseases instead of "killing" cancers.  We have known this for the past 30+ years that some cancers are dormant and while cancers are actively lethal. 

We've learned that some breast cancers are low-aggressive (but we need to continually watch them) or perhaps call for less aggressive treatment.  We've also learned that certain cancers may surprise us; they do not follow the expected guidelines due to continung mutation.  An example of this is the new findings of breast cancer cases in younger and younger ages (ie. 19 to 22 years old), and this age limit continues to get lower and lower.  

The same thing goes with breast cancers in men; five years ago, the count it used to be 1% of the population of cases, and now it's risen to 2% of the breast cancer population. We're finding more of it, partly thanks to better imaging access and partly because of improved awareness. 

Imaging innovations not only offers better detection but once we have the image, we can see if this is a "killing cancer" or not. The simplest technique and most basic technique is to use blood flow imaging. If we find many tumor vessels, "tumor's bad". If the tumor has only a few tumor vessels, tumor is "not so bad". More importantly, if you're treating a tumor and it goes from less to more, the treatment is not working. So we have a way of monitoring treatment in real time. 


Slide 1- shows a mass under the arm that is measured externally and internally. We employed 3D Doppler blood flow (for PreOp scan or prediagnostic scan) to find out where the cancer is and focus on that. We target before, during, and after treatment scan points. The slide also shows the blood flow readings- showing very few tumor vessels, which is a good sign. This indicates our new  ways of targeting tumor aggressiveness. 

Slide 2 shows a gland, allowing us to determine whether it is normal or abnormal. Clinically, this was a fatty tumor 'cause it was smooth and, and moved. But if you look carefully, it was not a breast cancer metastasis, but it was a, a primary cancer of the glands or the the bloodstream, which is useful. But again, it's radioactivity, it's isotopes. It, uh, takes a long time and it's expensive. 

Slide 3-  shows a mass and then we have a color on the far right slide, which is new for us because it's not a blood flow technology. This is elastography. When you feel a cancer, it's often hard like a piece of rock, whether it's in the breast, the prostate, the in the neck. And this is a non-invasive way of looking at tumors. It's called elastography because it shows the elastic nature of tumors. So if a tumor is rock hard, it's highly inelastic, and if it's soft, it's more elastic. 

And this is a quantitative technology that's used globally for the last 15 years. So we now have ways of seeing what a tumor is, where it is. And globally, people are deciding whether or not to biopsy a breast if there's nothing showing up by an ultrasound or ELAs that looks suspicious. And the Doppler blood flow is, looks, uh, either low grade or benign. So this is a, a filter which is just being recognized by the insurance companies and paid for now to decide whether the biopsy or not. Also, if the tumor is hard, like the, the vessels going into it and it becomes soft with few vessels and less elastic or less, uh, red in it on the gram, we have the ability to say that the treatment is working non aggressively without doing biopsies to see if it's gotten better or worse. 

So we're learning that biopsies can be hit or miss in the getting. They can be hit or miss in the sectioning. They can get the hit or miss in the interpretation at the end. Sorry to say that this is a problem, but you have to realize that the reason we went to advanced imaging is because it's safe, it's quick, it's repeatable without needles. Using the imaging, which I repeat is done globally now, to avoid biopsies and to avoid re-biopsying lesions to see if the treatment is working with the blood flow technology. The 3D Doppler, the advanced equipment will show you where the tumor is, what's happening to it. And once you see the blood vessels, you also have other options. For example, in if you have blood vessels feeding a tumor, now you can stick a catheter in the artery that's feeding the tumor and destroy the whole tumor by blocking the blood supply. 

Needle Biopsy (sample)
It's called infarct the tumor- used also in treating fibroids. Now we're treating certain cancers. You just kill the blood supply to the tumor if you know where it is. So these are options that weren't available before and are being accepted by medical community. For example, if there's a tumor in the breast, we look at the tumor, but then what next? The patient is sitting in front of you. So you may want to look under the arm to see if it's spread. And of course if you find it's metastasized to lymph nodes under the arm, you may say, and again, the patient's right in front of you, where else could it spread? Because treatment of disease that's only in the glands is different from treatment of cancers that spread to the well to the lymph nodes in the body or to the uh, liver for example. 

So it's a completely different approach. So then we ask the patient to lie down, put the probe over the lymph nodes over the aorta, the main blood vessel in the midline, and then we check the liver and then the other areas that can be affected. We can also look at the ribs to see if there's erosion of the bone by tumors, which commonly wind up in the rib cage. So we can do all of this at the same time. The patient is in front of us. 

ROBERT L. BARD, MD is internationally recognized in the field of 3D DOPPLER ULTRASOUND IMAGING to detect cancers (in organs including the breast, prostate, skin, thyroid, melanoma and other areas). As a certified diagnostic radiologist, Dr. Bard evolved his practice to pursue non-invasive 3D imaging with ultrasound, MRI and laser technologies. He is also passionate about conducting educational presentations and publishing in International Medical Journals. He holds Board certification from the American Board of Radiology (1974) and Fellowship in the American Society of Lasers in Medicine and Surgery (2014).


This page of PinkSmart News offers the latest in Global News about Breast Cancer and other Cancer Innovations which our editors find useful ...